Public Health Provider Charity Care Program (PHP-CCP) Overview
Learn about the Public Health Provider Charity Care Program (PHP-CCP) designed to provide reimbursement for healthcare services. Find out who is eligible, payment protocols, and program rules to participate in this initiative under the 1115 waiver.
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Presentation Transcript
Public Health Provider - Charity Care Program (PHP-CCP) Stakeholder Presentation
Introduction to PHP-CCP The Public Health Provider Charity Care Program (PHP-CCP) is designed to allow qualified providers to receive reimbursement for the cost of delivering healthcare services, including behavioral health services, vaccine services , and other preventative services, when those costs are not reimbursed by another source. The program is authorized under the 1115 waiver. 2
Introduction to PHP-CCP To qualify, providers must submit an annual application that will collect cost and payment data on services eligible for reimbursement under this program. The provider must be able to certify public expenditures and will be paid an annual lump sum based on actual expenditures. Year 1 of the program, DY11, will begin October 1, 2021 and end September 30, 2022. For the first two years, the program size will be $500 million each year. 3
Introduction to PHP-CCP: Who is Eligible? In accordance with the Special Terms and Conditions of the 1115 waiver, to participate in the program, providers must be funded by a unit of government to be able to certify public expenditures. Publicly-owned and operated providers eligible to participate include: Established under the Texas Health and Safety Code Chapters 533 and 534 and are primarily providing behavioral health services: Community Mental Health Clinics (CMHCs), Community Centers, Local Behavioral Health Authorities (LBHAs), and Local Mental Health Authorities (LMHAs), Local Health Departments (LHDs) and Public Health Districts (PHDs) established under the Texas Health and Safety Code Chapter 121. 4
Payment Protocol (Attachment T) The Payment Protocol (Attachment T) provides guidelines for the cost report tool which includes the following: Cost report period dates Definitions Directions for each exhibit 5
PHP-CCP TAC Rules RULE 355.8217 Payments to Public Health Providers for Charity Care RULE 355.8215 Public Health Provider - Charity Care Program (PHP-CCP) This section establishes the Public Health Provider - Charity Care Program (PHP-CCP). PHP-CCP is designed to allow qualified providers to receive reimbursement for the cost of delivering healthcare services, including behavioral health services, vaccine services, public health services, and other preventative services, when those costs are not reimbursed by another source. Beginning October 1, 2022, Public Health Provider - Charity Care Program (PHP-CCP) payments are available under this section for eligible providers to help defray the uncompensated costs of charity care. 6
Uncompensated Care vs. Charity Care Uncompensated Care Charity Care Health care provided for which a charge was recorded but no payment was received. Consists of two components: Charity Care patient is unable to pay. Bad Debt payment was expected but not received. Uncompensated care excludes other unfunded costs of care such as underpayment from Medicaid and Medicare. Healthcare services provided without expectation of reimbursement to uninsured patients who meet the provider s charity- care policy. Includes full or partial discounts given to uninsured patients who meet the provider s financial assistance policy. Does not include bad debt, courtesy allowances, or discounts given to patients who do not meet the provider s charity- care policy or financial assistance policy. *Uncompensated Care and Medicaid Shortfall will be included in the first year of the program. *Starting the 2nd year, the program will transition to Charity Care only. 7
Upcoming Dates for Year 1 and Year 2 DY11 Cost Reports Due to HHSC Nov 14th, 2022 DY11 Initial Training Opportunity - Upcoming DY11 Refresher Training (Aug-Sept 2022) Year 1 (DY11) DY12 Charity Care Training (April 2022) DY12 Initial Training (Aug-Sept 2022) Year 2 (DY12) 8
Provider Finance Contact Information Email: PHP-CCP@hhs.Texas.gov Phone: Customer Information: (512) 424-6637 or (512) 462-6223 Written Comments: HHSC, Mail Code H400, P.O. Box 13247, Austin, Texas 78711-3247 9
Questions? 10
